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r„r nn olita r19-nilnM Wnawdfar 1 Form Aooroved. OMB No. 2050-0039 <br />EPA Forr"70 A (Rev. 3-05). Previous editions are obsoleta. GENERATOR'S INITIAL COPY <br />UNIFORM HAZARDOUS WASTE MANIFEST <br />TIt. Great"t 14 Number. : ;` r <br />22. Page <br />23. Maq,fest Tr <br />ipg Imlp}r <br />(Continuation Sheet) <br />1� <br />24, Generator's Name <br />rw <br />]]��f 1 <br />- U.S. WAID Mwnber <br />25. Transporter Company Name �1 „ r' '; <br />!; <br />U.S. EPA ID Number <br />26. Transporter Company Name <br />27a. <br />27b. U.S. DOT Description Qnduding ProperShipping Name, Hazard Class ID Number, « <br />28. Containers„ <br />29�:Told - <br />30: Urd6 <br />, rf <br />HM <br />and Paring 6ror (ifarry}J- ,x — , — { <br />�]li A!Ihi <br />fltiR % <br />= Nd : <br />..Type <br />:?W,k <br />fJ <br />f <br />,2P''a..'Y "�t a..r'.� "C'�}+1`.*3f%"•ZL:"t.,.•-,' `. r,�r.,"•e'� e0if ..r3- <br />'Y. s!�k'S2P .:"�'-•.it1 r s'F: fit !'.; _ - _. _ _, <br />_,l. <br />. <br />�,•� <br />-� <br />32. Special Handling Instructions and Additlonai Information <br />a, <br />33. Trans orterAcknowled ent of Receipt of Materials <br />w <br />Printed/Typed Name f Signature Month Dey Yew <br />.� <br />p-. <br />v' ' I .. c �y <br />�j t • y wi <br />T� <br />-34.-Transpoder :. _. rAdmowledgment:of R 01Matarielff - - .. — - —'; -. ' ~ <br />PrintedlTyped Name Sipretub Meath Day Yeer <br />35. Discrepancy <br />J_ <br />LL <br />D <br />W <br />Q <br />36. Hazardous Waste Report Management Method Codes (i.e., codes for hazardous waste treatment, disposal, and recycling systems) <br />z <br />is <br />ar <br />w <br />a <br />EPA Forr"70 A (Rev. 3-05). Previous editions are obsoleta. GENERATOR'S INITIAL COPY <br />